ACUTE GASTROENTERITIS [Report by: Cherry Nolle Sanchez] Gastroenteritis is a condition that causes irritation and inflammation of the

stomach and intestines (the gastrointestinal tract). Causes: Viruses Noroviruses Rotavirus Other viruses that cause gastrointestinal symptoms include: Adenoviruses - This virus most commonly causes respiratory illness; however, other illnesses may be caused by adenoviruses such as gastroenteritis, bladder infections, and rash illnesses. Parvoviruses - The human bocavirus (HBoV), which can cause gastroenteritis belongs to the family Parvoviridae. Astroviruses - Astrovirus infection is the third most frequent cause of gastroenteritis in infants. Causes: Bacteria Bacteria may cause gastroenteritis directly by infecting the lining of the stomach and intestine. Some bacteria such as Staphylococcus aureus produce a toxin that is the cause of the symptoms. Staph is a common type of food poisoning. Escherichia coli Salmonella, Shigella and Campylobacter Clostridium difficile

The history and physical examination of children with gastroenteritis should focus on assessing for the presence and degree of dehydration and determining the underlying etiology. The child's weight during the illness versus posttreatment is often used to evaluate degree of dehydration retrospectively. The three examination signs that best suggest dehydration in children are an abnormal respiratory pattern, abnormal skin turgor, and prolonged capillary refill time, although parental report of the child's history is also helpful in the assessment. Symptoms Common gastroenteritis symptoms Low grade fever to 100 F (37.7 C) Nausea with or without vomiting Mild-to-moderate diarrhea Crampy painful abdominal bloating (The cramps may come in cycles, increasing in severity until a loose bowel movement occurs and the pain resolves somewhat.) More serious symptoms of gastroenteritis Blood in vomit or stool (blood in vomit or stool is never normal and the affected individual should call or a visit a health care professional.) Vomiting more than 48 hours Fever higher than 101 F (40 C) Swollen abdomen or abdominal pain Dehydration - weakness, lightheadedness, decreased urination, dry skin, dry mouth and lack of sweat and tears are characteristic signs and symptoms. Diagnostic Exams Complete Blood Count (CBC), Electrolytes, and kidney function tests. Stool samples may be collected and tested for blood or different types of infection. Treatment of gastroenteritis includes self-care and home remedies that are aimed at keeping the patient well hydrated to avoid dehydration. Medical treatment may be necessary if the patient becomes dehydrated and needs hospitalization to rehydrate via an IV solution. Some medications may be prescribed to treat some infections (for example, C. diff), to stop vomiting, and antidiarrheal medication to treat diarrhea (either over-the-counter or prescription), depending upon the condition of the patient and cause of gastroenteritis.

GASTROENTERITIS An infection or inflammation of the digestive tract, particularly the stomach and intestines CAUSES Viruses such as caliciviruses, rotaviruses, astroviruses and adenoviruses. CAUSES Bacteria such as the Campylobacter bacterium CAUSES Parasites such as Entamoeba histolytica, Giardia lamblia and Cryptosporidium CAUSES Bacterial toxins poisonous by-products caused by bacteria can contaminate food -Some strains of staphylococcal bacteria produce toxins that can cause gastroenteritis CAUSES Chemicals lead poisoning, for example, can trigger gastroenteritis CAUSES Drugs certain drugs, such as antibiotics, can cause gastroenteritis in susceptible people and can irritate the digestive tract INFECTIOUS GASTROENTERITIS Escherichia coli infection this is a common problem for travelers to countries with poor sanitation. Infection is caused by drinking contaminated water or eating contaminated raw fruits and vegetables. Campylobacter infection the bacteria are found in animal feces. Infection is caused by, for example, consuming contaminated food or water, eating undercooked meat (especially chicken), and not washing your hands after handling infected animals. INFECTIOUS GASTROENTERITIS Cryptosporidium infection parasites are found in the bowels of humans and animals. Infection is caused by, for example, swimming in a contaminated pool and accidentally swallowing water, or through contact with infected animals. An infected person may spread the parasites to food or surfaces if they dont wash their hands after going to the toilet.. Giardiasis parasite infection of the bowel. Infection is caused by, for example, drinking contaminated water, handling infected animals or changing the nappy of an infected baby and not washing your hands afterwards. INFECTIOUS GASTROENTERITIS Salmonellosis Bacteria are found in animal feces. Infection is caused by eating contaminated food or handling infected animals. An infected person may also spread the bacteria to other people or surfaces by not washing their hands properly. Shigellosis bacteria are found in feces. An infected person may spread the bacteria to food or surfaces if they dont wash their hands after going to the toilet. INFECTIOUS GASTROENTERITIS Viral Gastroenteritis viruses are found in human feces. Infection is caused by person-to-person contact such as touching contaminated hands, feces or vomit, or by drinking contaminated water or food. SYMPTOMS Low grade fever to 100 F (37.7 C) Nausea with or without vomiting Mild-to-moderate diarrhea Crampy painful abdominal bloating COMPLICATION The greatest danger presented by gastroenteritis is dehydration. The loss of fluids through diarrhea and vomiting can upset the body's electrolyte balance, leading to potentially life-threatening problems such as heart beat abnormalities (arrhythmia) The risk of dehydration increases as symptoms are prolonged. Dehydration should be suspected if a dry mouth, increased or excessive thirst, or scanty urination is experienced COMPLICATION

If symptoms do not resolve within a week, an infection or disorder more serious than gastroenteritis may be involved. Symptoms of great concern include a high fever (102 F [38.9 C] or above), blood or mucus in the diarrhea, blood in the vomit, and severe abdominal pain or swelling. These symptoms require prompt medical attention. DIAGNOSIS The symptoms of gastroenteritis are usually enough to identify the illness It is important to establish the cause, as different types of gastroenteritis respond to different treatments. Diagnostic methods may include: - Medical history - Physical examination - Blood tests - Stool tests APPROACH History Symptoms Nausea, emesis, retching Abdominal pain Bowel movements Timing Age Onset Relation to feeds Focus of infection, other affected individuals APPROACH Physical examination Temperature, heart rate, blood pressure, pain Abdominal examination Auscultation before palpation Palpation Masses Tenderness Auscultation for bowel sounds DIAGNOSIS History Stool examination Mucus Blood Leukocytes Stool culture Complete Blood Count (CBC), Electrolytes, and kidney function tests Objectives Assess the degree of dehydration Prevent spread of the enteropathogen Selectively determine etiology and provide specific therapy TREATMENT Treatment depends on the cause but may include: Plenty of fluids and Right Diet Oral rehydration drinks, available from your chemist Admission to hospital and intravenous fluid replacement, in severe cases TREATMENT Antibiotics, if bacteria are the cause Drugs to kill the parasites, if parasites are the cause Avoiding anti-vomiting or anti-diarrhea drugs unless prescribed or recommended by your doctor, because these medications will keep the infection inside your body Home-Made ORS:

PREVENTION General suggestions on how to reduce the risk of gastroenteritis include: Wash hands thoroughly with soap and water after going to the toilet or changing nappies, after smoking, after using a handkerchief or tissue, or after handling animals Wash your hands thoroughly with soap and water before preparing food or eating PREVENTION Use disposable paper towels to dry your hands rather than cloth towels, since the bacteria can survive for some time on objects Keep cold food cold (below 5C) and hot foot hot (above 60C) to discourage the growth of bacteria Make sure foods are thoroughly cooked PREVENTION Clean the toilet and bathroom regularly, especially the toilet seat, door handles and taps When travelling overseas to countries where sanitation is suspect, only drink bottled water. Dont forget to brush your teeth in bottled water too. Avoid food buffets, uncooked foods or peeled fruits and vegetables, and ice in drinks PROGNOSIS Gastroenteritis is usually resolved within 2 to 3 days and there are no long-term effects. If dehydration occurs, recovery is extended by a few days DISEASE PROCESS THANK YOU!!!

Gastroenteritis vs. Food Poisoning Specifically, gastroenteritis refers to infection/inflammation of the mucous membrane of the digestive tract, while food poisoning refers to a type of bacterial gastroenteritis that was caused by something the patient ate. Food poisoning can also refer to chemical food poisoning, as might happen if you ate a poisonous mushroom. In broad terms, gastroenteritis describes what the patient has, while food poisoning describes how the patient got it. Aspects of food poisoning Caused by contaminated food and/or water Spread by the consumption of any infected food product Causes abdominal pain, nausea, vomiting and diarrhoea Can lead to dehydration, kidney failure and reactive arthritis in severe cases. Food poisoning occurs when a food product is consumed which is contaminated by bacteria. These bacteria attach themselves to the lining of the intestines and start to multiply. Toxins are then released which attack cells within this lining that results in the symptoms described above. These toxins can be absorbed by the body which may cause problems elsewhere. So, food poisoning occurs due to the bacteria in the contaminated food and the toxins produced. Aspects of gastroenteritis Caused by an infection (viral or bacterial) Spread by personal contact although it can be transmitted through food or water. Causes fever, bloated abdomen, watery diarrhoea, aches and pains and vomiting. May lead to dehydration in serious cases Gastroenteritis develops when a virus or bacteria, such as norovirus, enters the digestive system. Once there it negatively interacts with organs such as the intestines, causing side effects such as diarrhoea. This virus or bacteria can react with food which passes through the digestive tract which results in an infection. A further reaction is where toxins are released into the digestive tract which can cause damage to the internal organs. One sign of this is an inflammation of the stomach or gastritis. So, gastroenteritis occurs as a result of a viral or bacteria infection within the digestive system (stomach and intestines). Viral vs. Bacterial Gastroenteritis Bacterial gastroentiritis (food poisoning) Bacterial gastroenteritis is an inflammation of the stomach and intestines caused by bacteria. It is also known as acute gastroenteritis or food poisoning. Bacterial gastroenteritis can affect anybody who has eaten the same food or drink and commonly occurs in cruise ships, hotels, at social functions or in restaurants. In this case the bacteria can enter the food in different ways: Contact with sewage water. Food prepared by someone who did not wash hands properly before handling. Food prepared with dirty or unclean cooking utensils. Dairy products or food containing mayonnaise that has been has been allowed to warm up for too long outside the fridge. Frozen or refrigerated foods that have not been stored at the proper temperature or have not been reheated properly. Contaminated raw fish or oysters. Raw fruits or vegetable that have not been washed properly. Raw vegetables or fruit juices and dairy products that have not been pasteurised. Eggs or meat that have not been properly cooked. Water from a contaminated natural source. Bacterial gastroenteritis symptoms The main symptom of bacterial gastroenteritis is diarrhoea however symptoms can vary depending on the bacteria. Symptoms may include: abdominal cramps or pain, bloody stools, loss of appetite, nausea and vomiting.

Most forms of bacterial gastroenteritis should only last a couple of days and we advise you to avoid dehydration by drinking plenty of fluids. This is especially important in young children who may be reluctant to drink. Should you or your child show any form of dehydration such as sunken eyes or reduction of urine production you must seek medical advice. However, most pharmacies sell medication that will help slow down or even stop the diarrhoea. You should feel better after a few days however please contact your GP should your symptoms change or if you have any of the following symptoms: Blood or pus or blacken stools. o Persistent diarrhoea with a fever of over 38 C. Recently returned from a foreign country and develop diarrhoea. Stomach pains that don t go away after a bowel movement. Symptoms of dehydration (thirst, dizziness or light headedness). The diarrhoea gets worse or doesn t get better after 2 days (children and infants) or 5 days for adults. Persistent vomiting for more than 12 hours in an infant over 3 months old. For those younger than 3 months call your GP as soon as the vomiting or diarrhoea begins. Viral gastroenteritis Viral gastroenteritis is often called 'stomach flu'. This is because it refers to swelling and inflammation of the stomach and intestines from a virus which can lead to diarrhoea and vomiting. Like bacterial gastroenteritis stomach flu can occur in one person or a group of people who have all eaten the same contaminated food or drunk the same contaminated water. Viral gastroenteritis is a leading form of severe diarrhoea in both adults and children and there are many types of viruses. The most common ones are: Norovirus common among the young. It may even cause outbreaks in hospitals and on cruise ships. Rotavirus the leading form of severe gastroenteritis in children and it can also adults who are in contact with children or those who live in nursing homes. Astrovirus - a mild form of gastroenteritis that often goes unreported and mainly affects children under the age of 5 years although it has been reported in adults as well. Outbreaks can occur in schools and nurseries. Enteric adenovirus an acute form of gastroenteritis in children worldwide. It is the third most common cause of infantile gastroenteritis after rotavirus and norovirus. Viral gastroenteritis symptoms The incubation period for viral gastroenteritis is usually about 4 - 48 hours after being contaminated with the virus. The symptoms, which may not appear for up to 2 days following infection, include: Abdominal pain Diarrhoea Nausea and vomiting Chills, clammy skin or sweating Fever Joint stiffness or muscular pain Poor feeding Weight loss We advise you to drink plenty of water and fluids especially if you have diarrhoea. To ensure that you don t dehydrate: Stay away from fruit juices, fizzy drinks either flat or bubbly, jelly or broths as these contain a lot of sugars which can make the diarrhoea worse. Drink small amounts of fluid about 100mls/3oz every 30-60 minutes. Don't drink large amounts of fluids at once as this may make you vomit. If you are breastfeeding a child who becomes ill, stop breastfeeding and change to soya milk until you have spoken with your GP. Like bacterial gastroenteritis the illness may last only for a few days without any treatment however should you become concerned or suffer from any of the follow please seek medical help: Blood in stools Confusion Dizziness Dry mouth Feeling faint Nausea No tears when crying No urine for 8 hours or more

Appearance of sunken eyes Sunken soft spot on an infants head